NURS 105 NCLEX QUESTIONS_Endocrine

NURS 105 NCLEX QUESTIONS_Endocrine (2020) – Faulkner CC (Medical Surgical Nursing)

Endocrine What effect on circulating levels of sodium and glucose does the nurse expect in a client who has been taking an oral cortisol preparation for 2 years because of a respiratory problem? (pg 1259)

• Decreased sodium; decreased glucose
• Decreased sodium; increased glucose
• Increased sodium; decreased glucose
• Increased sodium; increased glucose

Which hormone levels should the nurse expect to change in response to a client receiving a continuous cortisol infusion over a 24-hour period when the endocrine negative feedback mechanism is functioning properly? (7th edition pg 1364)

• Lower-than-normal serum cortisol levels; lower-than-normal serum ACTH levels
• Lower-than-normal serum cortisol levels; higher-than-normal serum ACTH levels
• Higher-than-normal serum cortisol levels; lower-than-normal serum ACTH levels
• Higher-than-normal serum cortisol levels; higher-than-normal serum ACTH levels

Which precaution or action is most important for the nurse to teach the client who is to collect a 24-hour-urine specimen for endocrine testing? (pg 1264)

• Eat a normal diet during the collection period
• Wear gloves when you urinate to prevent contamination of the specimen
• Urinate at the end of the 24 hours and add that sample to the collection container
• Avoid walking, running, dancing, or any vigorous exercise during the collection period.

Which client assessment finding indicates to the nurse the need to assess further for a possible endocrine problem? (7th edition pg 1367)

• A history of taking oral contraceptives for more than 2 years
• A weight loss of 5 lbs in the past 6 weeks without dieting
• The client’s father’s diagnosis of prostate cancer

• A recent need for corrective lenses

For which client does the nurse question the prescription for androgen replacement therapy? (pg 1268)

• 35-year-old man who has had a vasectomy
• 48-year-old man who takes prednisone for severe asthma
• 62-year-old man with a history of prostate cancer
• 70-year-old man who has hypertension and type 2 diabetes

Which precaution is most important for the nurse to teach the female client undergoing drug therapy with estrogen and progesterone for hypopituitarism? (7th edition pg 1373)

• “Use a nonhormonal form of contraception to prevent an unplanned pregnancy.”
• “Wear a hat with a brim and use sunscreen when outdoors.”
• “Do not smoke or use nicotine in any form.”
• “Avoid drinking alcoholic beverages.”

The nurse notes that the mustache dressing of a client who is 12 hours postoperative from a transsphenoidal hypophysectomy is wet. What is the nurse’s best action? (7th edition pg 1378)

• Reapply a dry dressing and document this expected response
• Ask the client whether other symptoms of a cold are present
• Notify the surgeon or the Rapid Response Team
• Test the drainage for the presence of glucose

Which urine properties indicate to the nurse that the client with syndrome of inappropriate antidiuretic hormone (SIADH) is responding to interventions? (pg 1273)

• Urine output volume increased; urine specific gravity increased
• Urine output volume increased; urine specific gravity decreased
• Urine output volume decreased; urine specific gravity increased
• Urine output volume decreased; urine specific gravity decreased

Which response in a client with diabetes insipidus indicates to the nurse that another dose of desmopressin acetate (DDAVP) is needed? (7th edition pg 1380)

• Urine output and specific gravity are increased
• Urine output is increased and urine specific gravity is decreased

• Urine output and specific gravity are decreased
• Urine output is decreased and urine specific gravity is increased

The serum electrolyte values for a client with syndrome of inappropriate antidiuretic hormone being treated with tolvaptan (Samsca) indicate the following changes within the past 12 hours.Which change does the nurse report immediately to the health care provider? (7th edition pg 1381)

• Serum potassium decrease from 4.2 mEq/L to 3.8 mEq/L
• Serum sodium increase from 122 mEq/L to 140 mEq/L
• Serum calcium increase from 9.5 mg/dL to 10.2 mg/dL
• Serum chloride decrease from 109 mEq/L to 99 mEq/L

The client who is about to have a unilateral adrenalectomy for an adenoma that is causing hypercortisolism asks the nurse if she will have to continue the severe sodium restriction after surgery. What is the nurse’s best response? (pg 1280)

• “No, once the tumor has been removed and your cortisol levels have normalized, you will

not retain excess sodium anymore.”

• “No, after surgery you will have to take oral cortisol, which can be easily controlled so that

your sodium levels do not rise.”

• “Yes, the fact that you are retaining sodium and have high blood pressure is related to your

age and lifestyle, not the tumor.”

• “Yes, sodium is very bad for people and everyone need to eliminate sodium completely from

their diets for the rest of their lives.”

Which precaution is most important for the nurse to teach a client who is prescribed oral corticosteroids for hormone replacement therapy after a unilateral adrenalectomy? (7th edition pg 1388)

• “Do not stop taking this drug without consulting your prescriber.”
• “Avoid crowds and people who are ill.”
• “Be sure to take this drug with food.”
• “Reduce your salt intake.”

Which manifestations are most often seen in general hyperthyroidism? Select all that apply (pg 1288)

• Increased appetite
• Cold intolerance

• Constipation
• Eyelid retraction
• Insomnia
• Palpitations
• Tremors
• Weight gain

Why is a goiter often present in clients who have Graves’ disease? (7th edition pg 1396)

• The low circulating levels of thyroid hormones stimulate the feedback system and trigger the

anterior pituitary gland to secrete more thyroid-stimulating hormone, which increases the numbers and size of glandular cells in the thyroid gland.

• The autoantibodies stimulate the inflammatory and immune responses to increase the

number of white blood cells circulating in the thyroid gland, which increases tissue size without increasing the number of glandular cells.

• The excessive autoantibodies bind to the thyroid hormone receptor sites, which increases

the number and size of glandular cells in the thyroid gland.

• The autoantibodies stimulate blood vessel growth and blood storage within the thyroid

gland, increasing its overall size.

For which assessment finding in a client who has severe hyperthyroidism does the nurse notify the Rapid Response Team? (pg 1291)

• An increase in premature ventricular heart contractions from 4 per minute to 5 per minute
• An increase in or widening of pulse pressure from 40 mm Hg to 46 mm Hg
• An increase in temperature from 99.5°F (37.5°C) to 101.3°F (38.5°C)
• An increase of 20 mL or urine output per hour

Which is the nurse’s most important assessment before giving the client prescribed levothyroxine (Synthroid) the first oral dose of the drug? (7th edition pg 1403)

• Measuring heart rate and rhythm
• Checking core body temperature
• Asking about an allergy to “sulfa” drugs
• Determining the level of gastric motility

The client has been taking levothyroxine (Synthroid) for 3 months reports all of the following conditions. Which condition indicates to the nurse that the drug dosage may need to be adjusted?(7th ed pg 1404)